Obliteration of the pelvic space with pedicled omentum after excision of the rectum for cancer.

From 1979 through 1982, removal of the rectum for cancer in 67 patients (50 of whom underwent preoperative radiotherapy) was completed by obliteration of the resulting dead space with pedicled omentum. No complication could be related to the method. After abdominoperineal resection (54 patients), primary healing of the perineal wound was achieved in 77 percent of the patients (85 percent during the last 2 years), and the mean postoperative hospital stay was 22 days. Minor perineal suppuration occurred in 10 patients with a 40 day average time of healing, and major suppuration occurred in 1 patient only with a 3 month time of healing. After the extended Hartmann operation (12 patients), no pelvic abscess was observed and the median hospitalization stay was 19 days. Pelvic filling in the management of patients undergoing rectal excision is an adjunctive procedure that is mainly intended to provide a better postoperative course. It might also facilitate postoperative radiotherapy.